Supportive periodontal therapy planning — ORE Part 1 MCQ

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HardPeriodontologySupportive periodontal therapy planningORE Part 1

A 60-year-old former smoker completed root surface debridement for Stage III periodontitis. Reassessment shows reduced bleeding but residual 5–6 mm pockets at molars and variable plaque control. He asks to return yearly because symptoms have improved. What is the most appropriate treatment?

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Correct answer: B — Risk-based supportive periodontal therapy with reinforcement and residual pocket management

The correct answer is B. Residual 5–6 mm pockets after Step 2 (root surface debridement) indicate treatment-resistant sites that warrant Step 3 intervention within a risk-based supportive periodontal therapy (SPT) framework. SDCEP guidance mandates that patients with residual probing depths ≥4–5 mm receive active management—including repeated instrumentation, reinforced plaque control, and possible specialist assessment for surgical options—not passive maintenance. The patient's risk profile (former smoker, variable plaque control, deep residual pockets) and the presence of bleeding argue against yearly recall; 3–6 month intervals are more appropriate. Option C (discharge) ignores disease activity and prognosis. Option D (antibiotics) lacks evidence and is not standard SPT. Option A (extraction) premature without proper Step 3 reassessment and specialist input. Option E (night guard) is irrelevant to periodontal pathology management.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Treatment of Periodontal Diseases in Primary Care. Updated 2024. https://www.periodontalcare.sdcep.org.uk/guidance/long-term-care/periodontitis/supportive-periodontal-care/